Provider Demographics
NPI:1225905458
Name:MOMMY ROGERS MOBILE PHLEBOTOMY
Entity type:Organization
Organization Name:MOMMY ROGERS MOBILE PHLEBOTOMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:475-306-1969
Mailing Address - Street 1:81 BRADLEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-3908
Mailing Address - Country:US
Mailing Address - Phone:475-306-1969
Mailing Address - Fax:475-306-1969
Practice Address - Street 1:81 BRADLEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-3908
Practice Address - Country:US
Practice Address - Phone:475-306-1969
Practice Address - Fax:475-306-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty